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坏死性小肠结肠炎的管理与预后

Management and outcome of necrotizing enterocolitis.

作者信息

Kanto W P, Wilson R, Ricketts R R

出版信息

Clin Pediatr (Phila). 1985 Feb;24(2):79-82. doi: 10.1177/000992288502400203.

Abstract

A survey of all cases of NEC in the State of Georgia during 1977 and 1978 identified 148 infants with NEC. Fifty-two of these infants were treated surgically, and the survival rate was 48 percent (26/54). The survival rate of medically treated patients was 68 percent (64/94) p less than 0.02. Survival was inversely associated with birthweight, although the survival rate following surgery was similar regardless of size. Age of presentation did not influence frequency of surgery or survival, but if perforation at surgery was present in smaller infants (less than or equal to 1500 g) the survival was less than if operation occurred prior to perforation (78% vs. 39%) p less than 0.05. The type of surgical procedure required also was associated with survival. The survival rate was greatest (90%) if only large bowel was removed and least (27%) if small bowel was resected. These results indicate the influence of birthweight, surgical procedure required, and presence or absence of perforation on survival and particularly surgical survival in NEC. They suggest that reviews of outcome in surgical management must take into account the extent of the surgical procedure that it was necessary to employ.

摘要

一项针对1977年和1978年佐治亚州所有坏死性小肠结肠炎(NEC)病例的调查,确定了148例患有NEC的婴儿。其中52例婴儿接受了手术治疗,生存率为48%(26/54)。接受药物治疗的患者生存率为68%(64/94),p<0.02。生存率与出生体重呈负相关,尽管无论婴儿大小,手术后的生存率相似。发病年龄不影响手术频率或生存率,但如果较小婴儿(小于或等于1500克)手术时存在穿孔,其生存率低于穿孔前进行手术的情况(78%对39%),p<0.05。所需的手术类型也与生存率相关。仅切除大肠时生存率最高(90%),切除小肠时生存率最低(27%)。这些结果表明出生体重、所需手术类型以及穿孔的有无对NEC患者的生存率尤其是手术生存率的影响。它们提示在评估手术治疗的结果时,必须考虑到所采用手术的范围。

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